Körperliche Aktivität und die Inzidenz gastrointestinaler Karzinome in prospektiven Studien: Eine Literaturübersicht

Physical activity may contribute to the prevention of gastrointestinal carcinoma through the reduction of adipose tissue, sex hormones, growth factors, chronic inflammation and oxidative stress. In addition, physical activity strengthens the intestinal microbiome. It also decreases the risks and symptoms of gastrointestinal diseases including gastroesophageal reflux disease, inflammatory bowel disease, colon adenoma, non-alcoholic steatohepatitis and pancreatitis. Prospective epidemiologic studies revealed statistically significant inverse relationships of physical activity to adenocarcinoma of the esophagus and cardia, colorectal carcinoma, intrahepatic hepatocellular carcinoma and pancreatic carcinoma. In contrast, additional prospective studies are required to clarify the relationship of physical activity to esophageal squamous cell carcinoma, gastric non-cardia carcinoma, carcinoma of the small intestine, and intra- and extrahepatic cholangiocarcinoma. © 2019, Springer Medizin Verlag GmbH, ein Teil von Springer Nature

Körperliche Aktivität und die Inzidenz gastrointestinaler Karzinome in prospektiven Studien: Eine Literaturübersicht

Physical activity may contribute to the prevention of gastrointestinal carcinoma through the reduction of adipose tissue, sex hormones, growth factors, chronic inflammation and oxidative stress. In addition, physical activity strengthens the intestinal microbiome. It also decreases the risks and symptoms of gastrointestinal diseases including gastroesophageal reflux disease, inflammatory bowel disease, colon adenoma, non-alcoholic steatohepatitis and pancreatitis. Prospective epidemiologic studies revealed statistically significant inverse relationships of physical activity to adenocarcinoma of the esophagus and cardia, colorectal carcinoma, intrahepatic hepatocellular carcinoma and pancreatic carcinoma. In contrast, additional prospective studies are required to clarify the relationship of physical activity to esophageal squamous cell carcinoma, gastric non-cardia carcinoma, carcinoma of the small intestine, and intra- and extrahepatic cholangiocarcinoma. © 2019, Springer Medizin Verlag GmbH, ein Teil von Springer Nature

RE: Physical activity and the risk of liver cancer: A systematic review and meta-analysis of prospective studies and a bias analysis.

Background Physical inactivity is an established risk factor for several cancers of the digestive system and female reproductive organs, but the evidence for liver cancers is less conclusive.Methods The aim of this study was to synthesize prospective observational studies on the association of physical activity and liver cancer risk by means of a systematic review and meta-analysis. We searched Medline, Embase, and Scopus from inception to January 2019 for prospective studies investigating the association of physical activity and liver cancer risk. We calculated mean hazard ratios (HRs) and 95% confidence intervals (CIs) using a random-effects model. We quantified the extent to which an unmeasured confounder or an unaccounted selection variable could shift the mean hazard ratio to the null.Results Fourteen prospective studies, including 6,440 liver cancers, were included in the systematic review and meta-analysis. The mean hazard ratio for high compared with low physical activity was 0.75 (95% CI=0.63 to 0.89; 95% prediction interval=0.52 to 1.07; I-2=64.2%). We estimated that 67.6% (95% CI=56.6% to 78.5%) of all true effect estimates would have a hazard ratio less than 0.8. Bias analysis suggested than an unobserved confounder would have to be associated with a 1.99-fold increase in the risk of physical activity or liver cancer to explain away the observed mean hazard ratio. An unaccounted for selection variable would have to be related to exposure and endpoint with a relative risk of 1.58 to explain away the mean hazard ratio.Conclusions Physical activity is inversely related to the risk of liver cancer. Further studies with objectively measured physical activity and quasi-experimental designs addressing confounding are needed

To stratify or not to stratify: Power considerations for population-based genome-wide association studies of quantitative traits.

Meta-analyses of genome-wide association studies require numerous study partners to conduct pre-defined analyses and thus simple but efficient analyses plans. Potential differences between strata (e.g. men and women) are usually ignored, but often the question arises whether stratified analyses help to unravel the genetics of a phenotype or if they unnecessarily increase the burden of analyses. To decide whether to stratify or not to stratify, we compare general analytical power computations for the overall analysis with those of stratified analyses considering quantitative trait analyses and two strata. We also relate the stratification problem to interaction modeling and exemplify theoretical considerations on obesity and renal function genetics. We demonstrate that the overall analyses have better power compared to stratified analyses as long as the signals are pronounced in both strata with consistent effect direction. Stratified analyses are advantageous in the case of signals with zero (or very small) effect in one stratum and for signals with opposite effect direction in the two strata. Applying the joint test for a main SNP effect and SNP-stratum interaction beats both overall and stratified analyses regarding power, but involves more complex models. In summary, we recommend to employ stratified analyses or the joint test to better understand the potential of strata-specific signals with opposite effect direction. Only after systematic genome-wide searches for opposite effect direction loci have been conducted, we will know if such signals exist and to what extent stratified analyses can depict loci that otherwise are missed

COVID or not COVID: attributing and reporting cause of death in a community cohort

Objectives: In Germany, deaths of SARS-CoV-2-positive persons are reported as 'death related to SARSCoV-2/COVID-19' to the Robert Koch Institute, Germany's main infectious disease institution. In 177 COVID-19-associated deaths reported in Regensburg, Germany, from October 2020 to January 2021, we investigated how deaths following SARS-CoV-2 infection were reported and whether cases with a death attributed to SARS-CoV-2 (COVID-19 death [CD]) differed from cases with a reported death from other causes (non-COVID-19 death [NCD]). Study design: This was an observational retrospective cohort study. Methods: We analysed descriptive data on the numbers of cases, deaths, age, sex, symptoms and hospitalizations. We calculated odds ratios (ORs) with 95% confidence intervals (95% CIs) and performed Chisquared/Fisher's exact test for categorical variables and the Wilcoxon rank-sum test for comparison of medians. Results: Deaths attributed to COVID-19 occurred primarily in elderly patients. The mortality rate and the case fatality ratio (CFR) increased with age. The median age and the prevalence of risk factors were similar between CD and NCD. Respiratory symptoms and pneumonia at the time of diagnosis were associated with death reported as CD. The odds of CD attribution in cases hospitalized because of COVID19 were 6-fold higher than the odds of NCD (OR: 6.00; 95% CI: 1.32 to 27.22). Conclusions: Respiratory symptoms/pneumonia at the time of diagnosis and hospitalization due to COVID-19 were associated with attributing a death to COVID-19. Numbers of COVID deaths need to be interpreted with caution. Criteria that facilitate attributing the cause of death among SARS-CoV-2 cases more uniformly could make these figures more comparable. (c) 2022 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved

Relationship between atopic dermatitis, depression and anxiety: A two-sample mendelian randomization study.

BACKGROUND: Growing evidence suggests that atopic dermatitis (AD) is associated with an increased risk of depressive disorders and anxiety. However, existing studies were observational and may uncover correlations but cannot easily disentangle non-causal or reverse-causal associations because these associations could be confounded and may not reflect true causal relationships. OBJECTIVES: We carried out a 2-sample Mendelian randomization (MR) study to examine the potential effect of AD on the risk of depressive disorders and anxiety. METHODS: Genetic instruments from the largest available genome-wide association study (GWAS) for AD (10,788 cases, 30,047 controls) were used to investigate the relation to broad depression (170,756 cases, 329,443 controls), major depressive disorder (MDD) (30,603 cases, 143,916 controls) and anxiety (5,580 cases, 11,730 controls). A set of complementary approaches were carried out to assess horizontal pleiotropy and related potential caveats occurring in MR studies. RESULTS: We observed no causal impact of AD on the risk of depressive disorders and anxiety, with close-to-zero effect estimates. The inverse weighted method revealed no associations of AD on broad depression (OR=1.014, P=0.4307), probable MDD (OR=1.004, P=0.5681), ICD-9/10-based MDD (OR=1.001, P=0.4659) or anxiety (OR=1.097, P=0.1801). CONCLUSIONS: In summary, this MR study does not support a causal effect of AD on depression and anxiety

Cardiorespiratory fitness and gray matter volume in the temporal, frontal, and cerebellar regions in the general population.

Objective: To analyze the association between cardiorespiratory fitness (CRF) and global and local brain volumes.Participants and Methods: We studied 2103 adults (21-84 years old) from 2 independent population-based cohorts (Study of Health in Pomerania, examinations from June 25, 2008, through September 30, 2012). Cardiorespiratory fitness was measured using peak oxygen uptake (VO(2)peak), oxygen uptake at the anaerobic threshold (VO2@AT), and maximal power output from cardiopulmonary exercise testing on a bicycle ergometer. Magnetic resonance imaging brain data were analyzed by voxel-based morphometry using regression models with adjustment for age, sex, education, smoking, body weight, systolic blood pressure, glycated hemoglobin level, and intracranial volume.Results: Volumetric analyses revealed associations of CRF with gray matter (GM) volume and total brain volume. After multivariable adjustment, a 1-standard deviation increase in VO(2)peak was related to a 5.31 cm(3) (95% CI, 3.27 to 7.35 cm(3)) higher GM volume. Whole-brain voxel-based morphometry analyses revealed significant positive relations between CRF and local GM volumes. The VO(2)peak was strongly associated with GM volume of the left middle temporal gyrus (228 voxels), the right hippocampal gyrus (146 voxels), the left orbitofrontal cortex (348 voxels), and the bilateral cingulate cortex (68 and 43 voxels).Conclusion: Cardiorespiratory fitness was positively associated with GM volume, total brain volume, and specific GM and white matter clusters in brain areas not primarily involved in movement processing. These results, from a representative population sample, suggest that CRF might contribute to improved brain health and might, therefore, decelerate pathology-specific GM decrease